Parasitology Research

, 99:379 | Cite as

Detection of parasitemia profiles by blood culture after treatment of human chronic Trypanosoma cruzi infection

  • Ana Maria de Castro
  • Alejandro Ostermayer Luquetti
  • Anis Rassi
  • Egler Chiari
  • Lúcia Maria da Cunha Galvão
Original Paper

Abstract

The change in parasitemia profile, measured by sequential blood cultures of 27 benznidazole (Bz) treated patients compared with 13 untreated patients, on the chronic phase of chagas disease, is described. All patients were adults (age limits: 23–88) with positive serology (three tests); 23 of them were females. All patients were submitted to six blood cultures, three before and three after Bz treatment. The parasitemia was classified as nondetected (with three negative blood cultures), medium (one positive culture in three), and high (two or three positive cultures). From the eight patients with nondetected parasitemia before Bz, seven still had the same profile and only one switched to medium; from eight with medium parasitemia, seven shifted to nondetected, and one to high parasitemia. From the 11 patients with high parasitemia before Bz, ten converted to nondetected and only one was positive after Bz. Nineteen of the 27 patients changed the parasitemia profile (70.4%), and the rate of therapeutic failure was 11.1% (3/27) during the first 24 months of follow-up after Bz. The shift to nondetected parasitemia profile was from 8/27 to 24/27 patients after Bz treatment for the first 2 years. Only 46.2% (6/13) of the nontreated individuals changed the parasitemia profile. We conclude that there is a strong trypanocide effect of Bz (88.8%) and a rate of therapeutic failure of 11.1% during the first 2 years after trypanocidal treatment.

References

  1. Andrade ALSS, Zicker F, De Oliveira RM, Almeida Silva S, Luquetti A, Travassos LR, Almeida IC, De Andrade SS, De Andrade JG, Martelli CM (1996) Randomized trial of efficacy of benznidazole in treatment of early Trypanosoma cruzi infection. Lancet 348:1407–1413CrossRefPubMedGoogle Scholar
  2. Andrade SG, Stocker GS, Pimentel AS, Grimaud JA (1991) Reversibility of cardiac fibrosis in mice chronically infected with Trypanosoma cruzi, under specific chemotherapy. Mem Inst Oswaldo Cruz 86:187–200PubMedGoogle Scholar
  3. Bronfen E, Rocha FSA, Machado GBN, Perillo MM, Romanha AJ, Chiari E (1989) Isolamento de amostras do Trypanosoma cruzi por xenodiagnóstico e hemocultura de pacientes na fase crônica da doença de Chagas. Mem Inst Oswaldo Cruz 84:237–240PubMedCrossRefGoogle Scholar
  4. Brumpt E (1914) Le xénodiagnostic. Application au diagnostic de quelques infections parasitaires et en particulier a la Trypanosomose de Chagas. Bull Soc Pathol Exot 7:706–710Google Scholar
  5. Cançado JR (2002) Long-term evaluation of etiological treatment of Chagas disease with benznidazole. Rev Inst Med Trop São Paulo 44:29–37PubMedGoogle Scholar
  6. Castro AM, Luquetti AO, Rassi A, Rassi GG, Chiari E, Galvão LMC (2002) Blood culture and polymerase chain reaction for the diagnosis of the chronic phase of human infection with Trypanosoma cruzi. Parasitol Res 88:894–900CrossRefPubMedGoogle Scholar
  7. Castro C, Macedo V, Prata A (1999) Comportamento da parasitemia pelo Trypanosoma cruzi em chagásicos crônicos durante 13 anos. Rev Soc Bras Med Trop 32:157–165CrossRefPubMedGoogle Scholar
  8. Castro C, Prata A (2000) Absence of both circadian rhythm and Trypanosoma cruzi periodicity with xenodiagnosis in chronic chagasic individuals. Rev Soc Bras Med Trop 33:427–430CrossRefPubMedGoogle Scholar
  9. Cerisola JA, Rohwedder R, Segura EL, Del Prado CE, Alvarez M, Martini GJ de (1974) El xenodiagnóstico. Buenos Aires, Imp Inst Nac Invest Cardiovasc p. 157Google Scholar
  10. Chiari E, Brener Z (1966) Contribuição ao diagnóstico parasitológico da doença de Chagas na sua fase crônica. Rev Inst Med Trop Sao Paulo 8:134–138PubMedGoogle Scholar
  11. Chiari E, Dias JCP, Lana M, Chiari CA (1989) Hemocultures for the parasitological diagnosis of human chronic Chagas’ disease. Rev Soc Bras Med Trop 22:19–23PubMedGoogle Scholar
  12. Coura JR, Abreu LL, Wilcox HPF, Petana W (1991) Evaluation of the xenodiagnosis of chronic Chagas patients infected ten years or over in an area where transmission has been interrupted-Iguatama and Pains, west Minas Gerais State, Brazil. Mem Inst Oswaldo Cruz 86:395–398PubMedGoogle Scholar
  13. Galvão LMC, Chiari E, Macedo AM, Luquetti AO, Silva AS, Andrade AL (2003) PCR assay for monitoring Trypanosoma cruzi parasitemia in childhood after specific chemotherapy. J Clin Microbiol 41:5066–5070CrossRefPubMedGoogle Scholar
  14. Higuchi ML (1997) Chronic Chagasic cardiopathy: the product of a turbulent host–parasite relationship. Rev Inst Med Trop São Paulo 39:53–60Google Scholar
  15. Jones ME, Colley DE, Tostes S, Lopes ER, Vnencak-Jones C, McCurley TL (1993) Amplification of a Trypanosoma cruzi DNA sequence from inflammatory lesion in human chagasic cardiomyopathy. Am J Trop Med Hyg 48:348–357PubMedGoogle Scholar
  16. Lages-Silva E, Ramirez LE, Silva-Vergara ML, Chiari E (2002) Chagasic meningoencephalitis in a patient with acquired immunodeficiency syndrome: diagnosis, follow-up, and genetic characterization of Trypanosoma cruzi. Clin Infect Dis 34:118–123CrossRefPubMedGoogle Scholar
  17. Luquetti AO (1997) Etiological treatment for Chagas Disease. The National Health Foundation of Brazil. Parasitol Today 13:127–128CrossRefGoogle Scholar
  18. Luquetti AO, Rassi A (2000) Diagnóstico laboratorial da infecção pelo Trypanosoma cruzi. In: Brener Z, Andrade ZA, Barral-Neto M (eds) Trypanosoma cruzi e Doença de Chagas, 2nd edn., Guanabara Koogan, Rio de Janeiro, Brazil, pp. 344–378Google Scholar
  19. Luz ZMP, Coutinho MG, Cançado JR, Krettli AU (1994) Hemocultura: Técnica sensível na detecção do Trypanosoma cruzi em pacientes chagásicos na fase crônica da doença de Chagas. Rev Soc Bras Med Trop 27:143–148PubMedGoogle Scholar
  20. Ministério da Saúde (1997) Tratamento etiológico da doença de Chagas. 2a. ed Brasília. Fundação Nacional de Saúde, Manual, p. 32Google Scholar
  21. Moser DR, Kirchhoff L, Donnelson JE (1989) Detection of Trypanosoma cruzi by DNA amplification using the polymerase chain reaction. J Clin Microbiol 27:1477–1482PubMedGoogle Scholar
  22. Pan American Health Organization (1999) Tratamiento etiológico de la enfermedad de Chagas: conclusiones de reunión de especialistas. Rev Patol Trop 28:247–279Google Scholar
  23. Rassi A, Luquetti AO (2003) Specific treatment for Trypanosoma cruzi infection (Chagas disease). In: Tyler KM, Miles MA (eds) American trypanosomiasis. Kluwer, Boston, pp. 117–125Google Scholar
  24. Sosa Estani S, Segura EL, Ruíz AM, Velázquez E, Porcel BM, Yampotis C (1998) Efficacy of chemotherapy with benzidazole in children in the indeterminate phase of Chagas disease. Am J Trop Med Hyg 59:526–529PubMedGoogle Scholar
  25. Sturm NR, Degrave W, Morel C, Simpson L (1989) Sensitive detection and schizodeme classification of Trypanosoma cruzi cells by amplification of kinetoplast minicircle DNA sequences: use in diagnosis of Chagas’ disease. Mol Biochem Parasitol 33:205–214CrossRefPubMedGoogle Scholar
  26. Urbina JA (1999) Parasitological cure of Chagas disease: Is it possible? Is it relevant? Mem Inst Oswaldo Cruz 94(suppl. I):349–355CrossRefPubMedGoogle Scholar
  27. Urbina JA, Payares G, Molina J, Sanoja C, Liendo A, Lazardi K, Piras MM, Piras R, Perez N, Wincker P, Ryley JF (1996) Cure of short and long-term experimental Chagas disease using D0870. Science 273:969–971PubMedCrossRefGoogle Scholar
  28. Viotti R, Vigliano C, Armenti H, Segura E (1994) Treatment of chronic Chagas disease with benznidazole: clinical and serologic evolution of patients with long-term follow-up. Am Heart J 127:151–162CrossRefPubMedGoogle Scholar
  29. Zhang L, Tarleton RL (1999) Parasite persistence correlates with disease severity and localization in chronic Chagas’ disease. J Infect Dis 180:480–486CrossRefPubMedGoogle Scholar
  30. World Health Organization (2002) Control of Chagas disease. Second report of the WHO Expert Committee. WHO Technical Report Series 905. GenevaGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Ana Maria de Castro
    • 1
  • Alejandro Ostermayer Luquetti
    • 1
    • 4
  • Anis Rassi
    • 2
  • Egler Chiari
    • 3
  • Lúcia Maria da Cunha Galvão
    • 3
  1. 1.Departamento de Microbiologia, Imunologia, Parasitologia e Patologia do Instituto de Patologia Tropical e Saúde PúblicaUniversidade Federal de GoiásGoiâniaBrazil
  2. 2.Departamento de Clínica MédicaFaculdade de Medicina—Universidade Federal de GoiásGoiâniaBrazil
  3. 3.Laboratório de Biologia do , Departamento de ParasitologiaInstituto de Ciências Biológicas—Universidade Federal de Minas GeraisBelo HorizonteBrazil
  4. 4.Laboratório de ChagasHospital das Clínicas da Universidade Federal de GoiásGoianiaBrazil

Personalised recommendations